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General NPI Number Information
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NPI Number | 1487816708
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Entity Type | Organization
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Legal Business Name | ST.CHRIS CARE AT NORTHEAST PEDIATRICS, LLC
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Dates
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Enumeration Date | 06/27/2008
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Last Update Date | 06/23/2016
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Provider Practice Location Address
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Address Line | ONE FALLS CENTER, 3300 HENRY AVENUE 4TH FLOOR
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City | PHILADELPHIA
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State | PA
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Zip | 19129
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Country | US
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Telephone | 215-509-2500
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Fax |
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Provider Business Mailing Address
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Address Line | ONE FALLS CENTER, 3300 HENRY AVENUE 4TH FLOOR
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City | PHILADELPHIA
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State | PA
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Zip | 19129
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | REGIONAL CFO, TENET
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Name | MR. WESLEY O. JAMES
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Credential |
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Telephone | 404-265-5009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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